Bone anchor locking device

ABSTRACT

A bone anchor locking device for receiving a bone anchor having a shank and an enlarged head, the device has a bone anchor, a dome and a conical split washer. The receiving portion has a base extending radially outward and inwardly to a wall. The dome has a center aperture sized to pass a bone anchor. The split washer has an inner conical surface sloped to slide and expand against at least a portion of the base on insertion of a bone anchor to allow a maximum diameter of a head of a bone anchor to pass and thereafter the split washer retracts overlying the maximum diameter of the head to prevent a bone anchor from backing out.

RELATED APPLICATIONS

The present invention is a division of U.S. application Ser. No.14/466,581 filed on Aug. 22, 2014 entitled, “Bone Anchor LockingDevice”.

TECHNICAL FIELD

The present invention is related to a bone anchor locking device andimplants such as cervical plates generally.

BACKGROUND OF THE INVENTION

The use of locking devices to prevent bone anchors from loosening iswell known in the art. Such anti-loosening devices are used on a varietyof implants and plate type devices. The present invention provides animprovement in such devices.

SUMMARY OF THE INVENTION

A bone anchor locking device for receiving a bone anchor having a shankand an enlarged head, the device has a bone anchor, a dome and a conicalsplit washer. The bone anchor receiving portion has a through hole sizedfor receiving and allowing the shank pass and holding the head. Thereceiving portion has a base extending radially outward and inwardly toa wall. The dome has a center aperture sized to pass a bone anchor. Thedome is fixed to the wall and spaced above the base to create a domedchamber. The conical split washer is positioned in the domed chamber.The washer has an inner relaxed inner diameter smaller than the head ofa bone anchor and an outer diameter larger than the center aperture ofthe dome and part of the base. The split washer has an inner conicalsurface sloped to slide and expand against at least a portion of thebase on insertion of a bone anchor to allow a maximum diameter of a headof a bone anchor to pass and thereafter the split washer retractsoverlying the maximum diameter of the head to prevent a bone anchor frombacking out.

The split washer is interposed between the base and the dome in thedomed chamber, wherein the split washer and the dome when abuttedpartially overlap combining to prevent a backing out of a bone anchor.The bone anchor locking device can be used with a cervical plate. One ormore of the bone locking devices are either formed integral to acervical plate or made separate and attached and fixed to the cervicalplate. For ease of manufacturing, the bone anchor locking device ispreferably made separate from the cervical plate. The bone anchorreceiving portion has the wall having an external surface for attachmentto the cervical plate. The external wall is preferably threaded andconfigured to be received in a threaded aperture of a cervical plate onassembly to the cervical plate. The inner conical surface of the washerslides against the base or at least partially along the base. The boneanchor locking device may have the bone anchor receiving portion whereinthe base includes a release rim or lip projection extending from andadjacent to the aperture opening of the base and the inner surface ofthe conical split washer slides over the lip or rim. The device can beformed as a subassembly for attachment to any spinal implant deviceconfigured to receive the subassembly.

A cervical plate assembly may have two or more apertures for receivingbone anchors for attachment to vertebral bodies. The cervical plate hasa plate body or body structure and a locking device. The plate or bodystructure has two or more openings for receiving a locking device. Onelocking device is for each opening. The locking device has a bone anchorreceiving portion, a dome and a conical split washer positionedinterposed between the dome and the bone anchor receiving portion. Thesplit washer and the dome when abutted partially overlap combining toprevent a backing out of a bone anchor. The cervical plate assemblywherein the bone anchor receiving aperture has a bone anchor receivingportion having a through hole sized for receiving and allowing the shankpass and holding the head. The receiving portion has a base extendingradially outward and inwardly to a wall. The dome has a center aperturesized to base and a bone anchor, the dome being fixed to the wall andspaced above the base to create a domed chamber. The conical splitwasher is positioned in the domed chamber having an inner relaxed innerdiameter smaller than the head of a bone anchor and an outer diameterlarger than the center aperture of the dome and the base. The splitwasher has an inner conical surface sloped to slide and expand againstthe base on insertion of a bone anchor to allow a maximum diameter of ahead of a bone anchor to pass and thereafter the split washer retractsto prevent a bone anchor from backing out. The bone anchor lockingdevices are either formed integral to a cervical plate or separated andattached and fixed to a cervical plate. Preferably, the bone anchorlocking device is made separate from a cervical plate. The bone anchorreceiving portion has the wall having an external surface for attachmentto a cervical plate. The external wall is threaded and configured to bereceived in a threaded aperture or hole of a cervical plate on assemblyto the cervical plate. Preferably, the device is formed as a subassemblyfor attachment to any spinal implant device configured to receive thesubassembly. The assembly has a plurality of fixing holes. One fixinghole extends through each of an intersection of the threads of the plateor body structure and the external wall. A plurality of fixing pins areprovided. One pin is press fit or otherwise fixed to each of the fixingholes to prevent thread loosening after assembly. The base of the boneanchor receiving portion can include a release rim or lip projectionextending from and adjacent to the aperture opening at the base. Therelease rim or lip projection has an outer wall and upon expansion ofthe split washer the inner surface of the washer slides along the rim orlip of the base. Also, an inner diameter edge of the washer can be heldagainst the outer wall of the rim or lip to allow removal of a boneanchor.

The invention provides novel methods of use. A method of releasing abone anchor locking device after the bone anchor has been fully insertedand locked comprises the steps of placing a tubular tool with achamfered end against an inner diameter surface or edge of a conicalsplit washer; pressing the tool inwardly expanding the washer as aninner conical surface of the washer slides at least partially along thebase to a diameter larger than the screw head to unlock the bone anchor;increasing the inside diameter of the tool; and removing the bone anchorby unthreading the bone anchor and passing through the tool. The step ofincreasing the tool diameter includes removing an inner sleeve leaving alarger diameter outer sleeve.

Another method of releasing a bone anchor locking device after the boneanchor has been fully inserted and locked comprises; placing a tubulartool with a chamfered end against an inner diameter surface or edge of aconical split washer; pressing the tool inwardly expanding the washer asit slides at least partially along the base to a diameter larger thanthe screw head to unlock the bone anchor; increasing the inside diameterof the tool; expanding the split washer to a diameter larger than a rimor lip diameter of the base; pushing the washer against a wall of therim or lip; and removing the released bone anchor. The method may havethe step removing the tubular tool prior to unthreading the releasedbone anchor. The base may optionally be conical sloped or tapered.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be described by way of example and with reference tothe accompanying drawings in which:

FIG. 1 is a top or plan view of an exemplary cervical plate assemblywith a locking device made according to a first embodiment of thepresent invention.

FIG. 2 is an exploded view of the assembly shown in FIG. 1.

FIG. 3 is a cross sectional view of the first embodiment of the presentinvention of FIG. 1.

FIG. 3A is an enlarged view of a portion of the embodiment shown in FIG.3 as shown in location 3A showing a bone anchor at initial assembly.

FIG. 4 is a cross section similar to FIG. 3 showing the expansionconical split washer as the maximum diameter of the head of the boneanchor contacts the washer.

FIG. 4A is an enlarged view taken in the location 4A of FIG. 4.

FIG. 5 is a cross sectional view of the fully inserted bone anchorsshowing the heads moved past the conical split washers and the washersretracted back to size overlying the maximum diameters of the heads.

FIG. 5A is an enlarged view taken from FIG. 5 at location 5A.

FIG. 6 is a second embodiment of the present invention shown in crosssection.

FIG. 7 is an exploded cross sectional view of the locking device made inaccordance with the second embodiment of FIG. 6.

FIG. 8 is a cross sectional view of the second embodiment of the presentinvention of FIG. 1.

FIG. 8A is an enlarged view of a portion of the embodiment shown in FIG.8 as shown in location 8A showing a bone anchor at initial assembly.

FIG. 9 is a cross section similar to FIG. 8 showing the expansionconical split washer as the maximum diameter of the head of the boneanchor contacts the washer.

FIG. 9A is an enlarged view taken in the location 9A of FIG. 9.

FIG. 10 is a cross sectional view of the fully inserted bone anchorsshowing the heads moved past the conical split washers and the washersretracted back to size overlying the maximum diameters of the heads.

FIG. 10A is an enlarged view taken from FIG. 10 at location 10A.

FIG. 11 is a cross sectional view of a locking device release tool forexpanding the conical split washer.

FIG. 12 is an enlarged cross section showing the feature of the secondembodiment wherein the conical washer can be held expanded by therelease ring.

DETAILED DESCRIPTION OF THE INVENTION

With reference to FIGS. 1-5A, a first embodiment of the presentinvention is illustrated. As shown, a bone anchor locking device 10 forreceiving a bone anchor 100 having a shank 110 and an enlarged head 120is illustrated. The bone anchor locking device 10 as illustrated inFIGS. 1 and 2 is composed of several elements. The first element is abone anchor receiving portion 4, 5 having a through hole 40 sized forreceiving and allowing the shank 110 to pass yet small enough to holdthe head 120. The receiving portion 4, 5 has a base 42 extendingradially outward and inwardly to a wall 41. This bone anchor receivingportion is designated as reference numbers 4 and 5. As shown, theseaperture portions 4, 5 have an external thread 44 which can be threadedto engage a threaded opening 12 in a cervical plate or implant device.The cervical plate or implant device has a body structure 1. It is intothe body structure 1 that the bone anchor locking device 10 can beassembled. As shown, the bone anchor locking device 10 further includesa split washer 2 and a dome 3. On assembly, the split washer fits belowthe dome and above the base 42 of the receiving portion 4, 5. Whenassembled to the body structure 1, the threaded receiving portions 4, 5are engaged into the threaded opening 12 of the body structure 1 andpinned using a pin 6 that is pressed into an opening 60 that intersectsthe threaded portions 12 of the body structure 1 and receiving portions4, 5 respectively. When so pinned, the assembly 10 cannot twist orunthread itself and is permanently locked to the body structure 1. Thispin 6 is press fit into the opening 60 and therefore secures the lockingdevice assembly 10 so that it cannot move or become dislodged.

With reference to FIGS. 3 and 3A, a bone anchor 100 is shown; the boneanchor has a shaft 110 and an enlarged head 120 in FIG. 3A. In theseviews, the bone anchor 100 is at its initial insertion position, it isextended through the dome 3 opening 30 and is resting against thesmaller internal diameter 20 of the conical split washer 2. As shown, anenlarged portion of the head 120 has a maximum diameter at location 126.The spring loaded washer 2 is effectively holding the threaded fasteneror bone anchor 100 above the base 42 and the through opening 40 in thereceiving portion 4 or 5.

With reference to FIGS. 4 and 4A, the bone anchor 100 is shown beingthreadingly engaged into a vertebrae (not illustrated). In thisposition, the spring washer 2 is being pushed inwardly and expandedalong the base 42 towards the maximum diameter portion 126. As thisoccurs, the washer 2 inside diameter 20 enlarges along an inner edge 22.As further shown, as this diameter 20 increases, the inner conicalsurface 21 of the split washer 2 is sliding along the base 42 of thereceiving portion 4. As shown the split washer 2 is shown resting andabutting against the surface 42 as it slides and expands to open as thethreaded fastener moves inwardly during the engagement of the bone. Thisholds true regardless of the angles of the base 42 and the inner conicalsurface 21 of the conical split washer 2 are the same. If these anglesare different, but directionally similarly sloped then at least aportion of the inner surface of the washer 2 will slide along the base42. As shown, the base 42 has a conical sloped surface. The base 42 ofthe illustrated first embodiment, while showing this feature can beconfigured in any number of shapes as long as they provide a means forthe inner conical surface to slide against.

With reference to FIGS. 5 and 5A, the bone anchor 100 is shown fullyinserted. At this point, the large or maximum diameter portion of thehead 120 at location 126 is allowed to be passed over past the conicalsplit washer 2. When this occurs, the expanded diameter 20 of theconical split washer 2 is released and returned to the original openingsize 20 of the split washer 2. As shown, the split washer 2 is nowpartially overlying locking the head portion 120 of the shank 110 andpreventing it from backing out. Assuming that the conical split washer 2is directionally pushed by the head 120 of the screw or bone anchor 100,it is noted that the dome 3 that is securely fastened to the inner wall41 of the receiving portion 4, 5 further reinforces the washer 2 helpingto resist any back-out of the threaded fastener or anchor 100.

Referring back to FIG. 3A, as illustrated, the receiving portion 4, 5has threads 44 that engage threads 12 through the opening in which thereceiving portion 4, 5 is received. As further shown, the pin 6 has beeninserted into the plate 1 as previously discussed thereby locking thereceiving portion 4, 5 in its position as illustrated. As shown thereceiving portion 4, 5 will have a central aperture opening 40 extendingtherethrough. This aperture 40 is designed to allow the shank 110 of thebone anchor 100 to pass. As illustrated this opening 40 is contoured insuch a fashion that as the bone anchor 100 is fully inserted, the head120 of the fastener will abut and be seated against the base 42. Asshown, the base 42 has been modified in this example to match and becomplimentary to the shape of the head 120. This base 42 provides a seatupon which the head 120 rests upon full insertion. The head 120 asfurther illustrated in the figures, has a central opening 122; thiscentral opening 122 receives a driving mechanism or drive that can beinserted to rotate and twist the screw or bone anchor 100 into the bone.As mentioned, the interior portion of the head 120 has a shape 124 thatis complimentary to the base 42.

An important feature of this first embodiment 10 and its exemplary plate1 is that the conical split washer 2 can be slid partially or entirelyalong the base surface 42 in such a fashion that the washer 2 expands asa direct result of the radially increasing and directionally inwardalong the base 42 forcing the washer 2 to open and enlarge the diameter20 so the maximum diameter 126 of the head 120 can pass and be lockedinto the washer 2 as the washer 2 returns to its original shape slidingback up the base 42 once past the location 126. A secondary feature ofgreat benefit is that the dome 3 which has been fixed to the inner wall41 of the receiving portion 4, 5 means that the resistance to pull outof the threaded bone anchor 100 is supported not only by the washer 2,but by the washer 2 underlying the overlapping dome 3. The dome 3 itselfwill provide additional resistance to any back-out.

With reference to FIGS. 6-10A, a second embodiment of the presentinvention is illustrated. This embodiment features the bone anchorlocking device 10A shown attached to an exemplary cervical plate 1 withall the elements previously discussed including the dome 3, conicalsplit washer 2, receiving portion 4, 5, and the fixing pins 6 to securebone anchors 100. As shown in FIG. 7, this subassembly can be referredto as 10S, this subassembly 10S is a combination of the receivingportion 4, 5, the dome 3 and the conical split washer 2 wherein thesplit 25 is illustrated. On assembly, this creates an entire bone anchorlocking device subassembly 10S. Additionally, but not part of the boneanchor locking device subassembly 10S is shown the bone anchor 100. Thisexemplary bone anchor can be substituted with any number of bone anchorswith any number or style of threads on the shank 110 and any style ofhead 120. The head 120 as shown is similar to that shown in FIGS. 1-5A,as previously discussed; however it is understood that this head shape120 can be a spherical dome, a polyaxial head or any number of shapeshaving a maximum diameter. The important aspect is the subassembly 10Scan be provided to fit with any implant device or any cervical plate orimplant used in spinal vertebrae attachment where bone anchors arerequired. While the bone anchor 100 does not make part of thesubassembly 10S, it is important to note that the locking devicesubassembly 10S whether it has the features of the first embodiment orthe second embodiment it is provided such that it can be attached to anyimplant device adapted with the threads 12 to engage the externalthreads 44 shown on the receiving portions 4 and 5.

With reference to FIGS. 8, 8A, 9, 9A, 10, 10A, the second embodiment isshown wherein the anchor 100 in FIGS. 8 and 8A is in the initialposition. In this case however, as illustrated the base 42 of thereceiving portion 4, 5 includes a rim or lip 52 projecting upwardly fromthe sloped surface 42. In this fashion, the split washer 2 is shownresting on this rim or lip 52. As shown the rim or lip 52 is supportingthe split washer 2 during the initial entry of a bone anchor 100. As thebone anchor 100 is engaged into the vertebrae (not shown) inner conicalsurface 21 of the split washer 2 rides against this rim or lip 52 as itis pushed and extends downwardly in a direction similar to or the sameas the base 42. The rim or lip 52 may hold the washer 2 slightly gappedabove the surface of the base 42 on at least part of the surface closestto the rim or lip 52. It is understood that the washer 2 depending onthe shape of the screw head being inserted can at least partiallycontact and slide down the surface of the base 42 or the rim or lip 52of the base 42. In any event, it will directionally move in a similardirection to the slope of the conical inner surface 21 of the washer 2as the head 120 of screw 100 pushes the split washer 2 into an expandedcondition as illustrated in FIGS. 9 and 9A. As best illustrated in 9Awhen the maximum diameter is achieved, the split washer 2 is stillsitting above on the rim or lip 52 slightly gapped from the rest of thebase portion 42. Upon further and complete insertion of the bone anchor100, the washer 2 will then slide back into position similar to thefirst embodiment wherein the washer 2 returns to its normal sizediameter 20 and the inner edge 22 of the split washer 2 will hold themaximum diameter of the head 120 in its retained and locked positionpreventing back-out. As previously noted in this embodiment, the dome 3will assist in resisting any back-out of the anchor 100.

With reference to FIGS. 11 and 12, this rim or lip portion 52 of thebase 42 as illustrated is shown with a locking release tool 80. Forbetter visualization, the bone anchor screw 100 and its head have beenremoved from the assembly so that the observation can be made as to howthe tool 80 can expand the split washer 2 in such a fashion that it willopen directionally the same as is accomplished with the head of thethreaded fastener. However, as the tool 80 pushes down, it has achamfered surface 86, this chamfered surface 86 extends along the entiretool 80. As shown, the tool 80 in this embodiment has an inner sleeve 84and an outer sleeve 82. This allows the tool 80 to have a small diameteron the inner sleeve 84 as it initially contacts the locking washer 2 andslides down against the inner edge 22 of the inner diameter 20 of theconical split washer 2 and pushes it directionally parallel to theconical slope. As the tool 80 is pushed further it is shown in FIG. 12how the inner edge 22 of the washer 2 will abut at the diameter 20against the rim 52 wall. When the inner edge 22 of the washer 2 buttsagainst this surface or wall, the washer 2 is docked on the base 42retained in a fully open position by the rim or lip 52. It is in thisposition where a surgeon can take a retraction tool or driver andunthread the bone anchor 100 from the vertebrae. In this fashion, thelocking device 10 provides a releasable feature. As illustrated, thetool 80, will also work with the first embodiment. However, with thefirst embodiment, the tool 80 must remain in place and the inner sleeve84 removed when the maximum diameter of the tool 80 is achieved. Themaximum inside diameter of the outer sleeve 82 is larger than themaximum diameter 126 of the head of the screw 100. So when this innersleeve 84 is removed the outer sleeve 82 can hold the conical splitwasher 2 in place and a driver can be used to unthread the bone anchor100 releasing it from the vertebrae while holding the tool 80 in place.The second embodiment eliminates the need to hold the tool 80 in placeas the conical split washer 2 can be docked and positioned abutting thelip 52 of the base 42 of the receiving portion 4, 5 to keep it in afully open position in the absence of any tool being positioned as thesurgeon removes the fastener 100. In either case, the tool 80 will workwith either embodiment increasing the diameter such that the splitwasher 2 will not interfere with the release of a threaded fastener 100once attached to the bone. This is important should a surgeon need toremove any of the fasteners previously installed such that the cervicalplate or the implant device that is being anchored, can be released fromthe locking device.

By expanding the conical washer 2 by pressing the washer conical innersurface 21 against the base 42 greatly reduces the forces required toenlarge the diameter of the conical split washer 2. The forces aretangential to the slope of the surface 21. This means that fraction ofthe forces acting on the threads of the bone anchor as they engage thebone are less making it easier to drive the bone anchor withoutstripping the bone threads as compared to prior art locking devices.

Variations in the present invention are possible in light of thedescription of it provided herein. While certain representativeembodiments and details have been shown for the purpose of illustratingthe subject invention, it will be apparent to those skilled in this artthat various changes and modifications can be made therein withoutdeparting from the scope of the subject invention. It is, therefore, tobe understood that changes can be made in the particular embodimentsdescribed, which will be within the full intended scope of the inventionas defined by the following appended claims.

What is claimed is:
 1. A method of releasing a bone anchor that has beenfully inserted and locked in a bone anchor locking device comprising;placing a tubular tool with a chamfered end against an inner diametersurface or edge of a conical split washer; pressing the tool inwardlyexpanding the washer as the inner surface or edge of the washer slidesat least partially along a base of the locking device to a diameterlarger than a screw head to unlock the bone anchor; increasing an insidediameter of the tool; and removing the bone anchor by unthreading thebone anchor and passing it through the tool.
 2. The method of claim 1wherein the step of increasing the tool diameter includes removing aninner sleeve leaving a larger diameter outer sleeve.
 3. The method ofclaim 1 wherein the base is conically sloped.
 4. A method of releasing abone anchor that has been fully inserted and locked in a bone anchorlocking device comprising; placing a tubular tool with a chamfered endagainst an inner diameter surface or edge of a conical split washer;pressing the tool inwardly expanding the washer as it slides at leastpartially along a base of the locking device to a diameter larger than ascrew head to unlock the bone anchor; expanding the split washer to adiameter larger than a rim or lip diameter; pushing the washer against awall of a rim or lip; increasing an inside diameter of the tool; andremoving the bone anchor by unthreading the bone anchor and passing itthrough the tool.
 5. The method of claim 4 further comprises increasingthe inside diameter of the tool prior to unthreading the unlocked boneanchor.
 6. The method of claim 4 wherein the base is conically sloped.